Usefulness of the Cameron tracheostomy scoring system after oral tumor surgery

被引:5
作者
Benatar-Haserfaty, J. [1 ]
Picon-Molina, M. [2 ]
Melendez-Salinas, D. A. [1 ]
Palacios-Lopez, C. [1 ]
机构
[1] Hosp Univ Ramon & Cajal, Serv Anestesiol, Madrid, Spain
[2] Hosp Univ Ramon & Cajal, Serv Cirugia Maxilofacial, Madrid, Spain
来源
REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION | 2014年 / 61卷 / 07期
关键词
Endotracheal extubation; Tracheostomy; Airway management; Complications; Score; Head and neck cancer;
D O I
10.1016/j.redar.2014.02.009
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objectives: The aim of this study was to analyze the results of applying the predictive score (PS) of Cameron to perform elective tracheostomy (ET) in oral tumor surgery. Material and methods: A retrospective and descriptive study was conducted on consecutive patients undergoing oral tumor surgery between January 2010 and December 2012. Items of the PS were collected: reconstruction and type of graft, mandibulectomy, bilateral neck dissection, and tumor location. Patients were grouped according to the management of the airway at the end of surgery into 4 groups: extubated, intubated, ET, and urgent tracheostomy. A cutoff of 5 points PS was considered for conducting ET. Results: A total of 90 patients were included. Group distribution was: extubated = 27.8%, intubated = 17.8%, ET = 53.3%, and one case (1.1%) of urgent tracheostomy. Using the cutoff value of PS >= 5 points yielded a diagnostic sensitivity value of 0.7 for a 95% confidence interval (CI) (0.57 to 0.82), and a diagnostic specificity value of 0.9 (95% CI 0.79 to 0.99). The PPV was 0.9 (95% CI 0.81 to 0.99) and the NPV was 0.67 (95% CI 0.54 to 0.8). The AUC gave a value of 0.87 (standard error 0.36). The likelihood ratio was 6.48. Conclusion: The decision to perform an ET for oral tumor surgery can be enhanced using the PS of Cameron based on objective data. (C) 2013 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L. All rights reserved.
引用
收藏
页码:369 / 374
页数:6
相关论文
共 17 条
[1]   Practice Guidelines for Management of the Difficult Airway An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway [J].
Apfelbaum J.L. ;
Hagberg C.A. ;
Caplan R.A. ;
Connis R.T. ;
Nickinovich D.G. ;
Benumof J.L. ;
Berry F.A. ;
Blitt C.D. ;
Bode R.H. ;
Cheney F.W. ;
Guidry O.F. ;
Ovassapian A. .
ANESTHESIOLOGY, 2013, 118 (02) :251-270
[2]   Need for Emergency Surgical Airway Reduced by a Comprehensive Difficult Airway Program [J].
Berkow, Lauren C. ;
Greenberg, Robert S. ;
Kan, Kristin H. ;
Colantuoni, Elizabeth ;
Mark, Lynette J. ;
Flint, Paul W. ;
Corridore, Marco ;
Bhatti, Nasir ;
Heitmiller, Eugenie S. .
ANESTHESIA AND ANALGESIA, 2009, 109 (06) :1860-1869
[3]   Development of a tracheostomy scoring system to guide airway management after major head and neck surgery [J].
Cameron, M. ;
Corner, A. ;
Diba, A. ;
Hankins, M. .
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2009, 38 (08) :846-849
[4]   Extubation of the Difficult Airway and Extubation Failure [J].
Cavallone, Laura F. ;
Vannucci, Andrea .
ANESTHESIA AND ANALGESIA, 2013, 116 (02) :368-383
[5]   Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia [J].
Cook, T. M. ;
Woodall, N. ;
Frerk, C. .
BRITISH JOURNAL OF ANAESTHESIA, 2011, 106 (05) :617-631
[6]  
de la Linde Valverde C M, 2005, Rev Esp Anestesiol Reanim, V52, P557
[7]   INCIDENCE AND MORBIDITY OF EXTUBATION FAILURE IN SURGICAL INTENSIVE-CARE PATIENTS [J].
DEMLING, RH ;
READ, T ;
LIND, LJ ;
FLANAGAN, HL .
CRITICAL CARE MEDICINE, 1988, 16 (06) :573-577
[8]   Risk factors for postoperative complications in major head and neck surgery [J].
Espinosa Dominguez, E. ;
Reveron Gomez, M. A. ;
Perez Mendez, L. ;
Martinez Gimeno, C. ;
Moure Garcia, E. ;
Yanes Luque, E. .
REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION, 2011, 58 (04) :218-222
[9]   Difficult extubation: Extubation criteria and management of risk situations - Question 6 [J].
Francon, D. ;
Jaber, S. ;
Pean, D. ;
Bally, B. ;
Marciniak, B. .
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION, 2008, 27 (01) :46-53
[10]   Analysis of tracheostomy-associated morbidity after operations for head and neck cancer [J].
Halfpenny, W ;
McGurk, M .
BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY, 2000, 38 (05) :509-512